Pain guide · Foot pain

Plantar plate tear: second toe pain, a toe that drifts or lifts, and what taping, shoes and surgery can do

The plantar plate is a thick pad under the joint at the base of each toe that stops the toe bending back too far. When it tears, usually under the second toe, the joint hurts and swells, it can feel like walking on a marble, and over time the toe may drift towards the big toe or lift off the floor. It's commonest in women over 50 and is often mistaken for metatarsalgia or Morton's neuroma. The big toe's version is turf toe.

Most people start with protection: taping the toe gently downwards, firm-soled shoes, a pad behind the joint and an NHS programme of toe and foot exercises, and many never need surgery. If pain and deformity persist, surgeons can repair the plate. This guide explains how it's recognised, what scans show and the evidence for each treatment, with written taping and toe-exercise steps and a staged plan with 3D demos.

3-stage exercise plan When to get help 33 sourcesUpdated 21 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Call 999 or go to A&E: after an injury, you heard a crack, the foot or ankle has changed shape or points at an odd angle, a bone is sticking out, there is a bad cut over it, you're in severe pain, or the toes look blue or white, feel numb or are cold to touch. These can mean a broken bone. Don't drive yourself.
Go to A&E if you think you have broken your big toe, the toe is pointing at an odd angle, the bone is sticking out, you feel tingling in your toe or foot or it feels numb, or your child has hurt or broken their toe. Ask someone to drive you or call 999 for an ambulance.
Contact NHS 111 if you have badly hurt your big toe, you're in severe pain, you feel faint, dizzy or sick from the pain, you have any tingling or loss of sensation in your foot, you heard a snap, grinding or popping noise at the time of the injury, you have difficulty moving your toes or you cannot walk, or you have toe pain and feel hot, cold or shivery.
Contact NHS 111 if your foot is hot, swollen and painful, or you have pain in the ball of your foot and feel hot, cold or shivery. These might be signs of an infection.
Same day: a sudden, very painful, hot, swollen, red joint, often the big toe, especially with a high temperature, feeling shivery or being unable to eat. It may be gout, but it could be a joint infection (septic arthritis), which is urgent.
Same day: you have diabetes and a new foot problem, such as an ulcer or wound, signs of infection, or a hot, swollen foot with a change in colour, even if it doesn't hurt. Contact your diabetes foot team or GP: NICE asks for these to reach a specialist foot service within 1 working day, and a suspected Charcot foot is kept off weight until it has been checked.
After surgery: redness, swelling, oozing or a smell from the wound, or a fever. Contact your surgical team the same day, or NHS 111 out of hours.
Same day, after toe surgery: pain that is getting worse, toes that are numb, burning, swollen, blue or white, or a dressing or strapping that feels too tight. Contact your surgical team, or NHS 111 out of hours.
Same day (GP or NHS 111): throbbing pain and swelling in one calf, with red or darker skin. It could be a blood clot (DVT). Watch for it after an ankle injury or time in a cast or boot.
Call 999: calf or leg pain or swelling with breathlessness or chest pain. It could be a clot that has reached the lungs.

See a doctor or physiotherapist if

A second toe that is drifting across its neighbour or lifting off the ground, or pain and swelling under its base: see a GP or podiatrist. The joint at the base of the toe may be unstable.
Pain that isn't better after 2 weeks of looking after it yourself, is getting worse, keeps coming back, or stops you doing normal things.
The exercises cause a large increase in pain, or nothing has changed after 12 weeks: contact your GP, as an NHS board advises.
Tingling, burning or numbness between the toes: that points to a nerve, such as Morton's neuroma, rather than the joint. See a GP if it persists.
You have diabetes or numb feet: don't tape over broken skin, and check the skin under the tape each time you change it, because long-term taping can cause skin ulcers. Any foot pain with diabetes needs a check, as foot problems can be more serious.
One spot on a foot bone that hurts with every step and later at night: a possible stress fracture.
Swelling and pain in several toe joints, or in both feet, with stiffness in the mornings: see a GP. Joint inflammation such as rheumatoid arthritis can look similar.
Pain and deformity that persist despite about 3 months of taping, shoes and pads, or a toe that is fixed out of place: ask about seeing a podiatric surgeon or an orthopaedic surgeon.

Understand it

What it is

Under the main joint at the base of each toe (the metatarsophalangeal joint) is a thick pad of tough, rubbery tissue called the plantar plate. Together with the ligaments at the sides of the joint, it is the joint's main support, stopping the toe bending back too far and keeping it in line.

A tear, usually where the plate joins the toe, lets the toe bend up and drift. Over time the joint can partly or fully dislocate, and the toe can cross over its neighbour (a crossover toe), lift off the floor (a floating toe) or curl (claw). Surgeons grade it from 0, pain and swelling in a stable joint, to 4, a dislocated joint with a fixed bent toe.

Sources 1, 2, 3

Who gets it

In 154 people at a UK foot clinic, 82% were women and the median age was 56. The second toe alone was affected in 64%, and the second toe was always involved when several toes were. In 169 people operated on for a crossover second toe, 86% were women, with an average age of 59, and bunions and big toe arthritis were more common than expected.

A review gives an average age of 60, or 50 in athletes, who make up 26% to 79% of cases depending on the clinic, and notes that it is often in both feet. High heels, bunions and a long second toe are commonly blamed, though the study of 169 crossover toes found no link with the length of the second metatarsal. An NHS board also lists extra weight, weak foot muscles, soft or flexible shoes, flat feet, inflammatory arthritis, running and jumping, and some jobs.

Sources 4, 5, 2, 3

How it feels and how it's recognised

Pain under the ball of the foot at the base of the second toe, like walking on a stone or a marble, with swelling, hard skin, a toe that drifts, splays or lifts, a weaker grip with that toe, and rubbing on top of the toe in shoes. It usually comes on gradually.

The drawer test is the key examination: the clinician steadies the foot bone and pushes the base of the toe upwards, and too much movement is a positive result. It's a useful test, but studies disagree on how accurate it is. In 90 people whose tears were repaired, it picked up 80.6% of tears and was rarely positive without one, but a study in cadavers found false positives in about 1 in 6, and a mildly positive test was found in about 1 in 3 people without symptoms and with a normal ultrasound scan.

A clinician may also check whether you can grip a strip of paper under the toe. A toe that crosses over its neighbour is a late sign: it was present in only 8% of confirmed tears.

Sources 3, 6, 7, 1, 2

Look-alikes

Morton's neuroma gives burning or shooting pain and numbness between the toes, usually the third and fourth, without a loose joint. The two can occur together, and in one review 3% to 14% of people with this kind of toe joint instability had had neuroma surgery that didn't help. Swelling in several toe joints, often in both feet with morning stiffness, points to joint inflammation such as rheumatoid arthritis.

Pain on top of a metatarsal bone that's worse with every step can be a stress fracture; collapse of the head of the second metatarsal (Freiberg's disease) affects teenagers and young adults; a swollen fluid sac between the bones can mimic both a neuroma and a plate tear; and gout can too. A big toe that was bent back in sport is turf toe.

Sources 2, 1, 8

What scans do and don't meanEmerging evidence

X-rays show indirect signs, such as a toe sitting up or drifting, and rule out bone problems. Ultrasound and MRI (magnetic resonance imaging) both did well in small studies checked against surgery or dissection: an MRI sign of scarring around the joint was right in about 91% of 45 joints, ultrasound was right in 79% of cadaver toes, and MRI with the toes bent up raised the pick-up rate from 75% to 100% in 15 patients.

Unlike many scan findings, a torn plate is rarely seen in people without forefoot pain: in 2% of 165 people having foot MRI for other reasons, against 28% of 53 with forefoot symptoms. Wear short of a tear was seen in 24% of 105 feet with ball-of-foot pain. So a tear on a scan that matches the examination usually matters, and a scan helps most when the diagnosis is unclear or surgery is planned.

Sources 2, 9, 10, 11, 12, 13, 3

How it usually goesEmerging evidence

It tends to progress slowly, from inflammation of the joint to partial and then full dislocation, which gives time to catch it early. An NHS board says ligament injuries in the foot can take 3 to 6 months to heal, and that the exercises can take up to 12 weeks to bring a clear improvement.

In the UK clinic, 64% were managed without surgery and did as well as those who had an operation. A case report followed a tear healing on MRI over a year of non-surgical care, and a professional dancer was dancing pain-free a year after a 16-week programme.

Sources 2, 3, 4, 14, 15

What helps, and how strong the evidence is

Care without surgery: as good as surgery in one UK cohortEmerging evidence

In 154 people at a UK foot clinic, the 99 treated with taping, shoe changes and injections had foot function scores (69 against 67 out of 100), pain and satisfaction (52% against 66%) that didn't differ significantly from the 55 who had surgery. This wasn't a randomised trial, so the groups may have differed in other ways.

A 2022 review notes that success without surgery rests on case reports and series, and that non-surgical care doesn't help once the deformity is advanced. A 2020 review says it suits the early grades best.

Sources 4, 16, 2

Protect and offload: taping, pads and firm shoesEmerging evidence

While the joint is inflamed, a review advises a stiff or rocker-soled shoe, or a postoperative shoe if a clinician supplies one, with no weight-bearing sport until pain and swelling have greatly settled, which can take from a week to 6 months. The toe is taped about 10° downwards so the plate can scar down; if taping is a problem, a sole pad with an elastic loop round the toe (a Budin splint) does a similar job. Once the joint has settled, a metatarsal pad sits 3 to 4 cm behind the joint, and the review says sport can resume when the joint is stable on the drawer test.

An NHS board advises taping for 4 to 6 weeks or until symptoms settle, no barefoot walking until the pain has gone, and firm, laced shoes with a heel no higher than 1.5 inches, ideally with a rocker sole. None of this has been tested in a trial, but case reports describe a tear healing on MRI and a professional dancer back to full duties with taping and padding.

Sources 2, 3, 6, 14, 15

Toe and foot exercises: an NHS programme, untested in trialsEmerging evidence

NHS Ayrshire and Arran's programme combines calf stretches with six strengthening exercises for the small muscles of the foot, built up to 3 sets of 15 once a day. It warns that symptoms may rise slightly at first and that a clear improvement can take up to 12 weeks. It is health-service advice, not a tested programme.

Source 3

Steroid injections: short-term help, with a warningMixed evidence

Older series of a steroid injection plus a rocker-soled shoe for inflammation of the toe joint reported 60% of joints symptom-free and 33% improved in 15 joints, and about 70% symptom-free in 9 feet followed for over 6 years. But progressive deformity developed in such series, and a review warns, as expert opinion, that repeated injections may weaken the plate further and raise the risk of the toe dislocating. If one is given, the review advises taping or splinting the toe and limiting weight-bearing for 6 weeks.

Sources 17, 18, 2

Platelet-rich plasma: one small seriesMixed evidence

In 20 people (23 feet) who hadn't improved with non-surgical care, a 100-point foot score improved by 32 points over an average of almost 5 years after a platelet-rich plasma (PRP) injection, and 13% later had surgery. There was no comparison group.

Source 19

Repair surgery: good results in case series, but not a cure-allEmerging evidence

Surgeons repair the plate directly, from the top (often with an operation to shorten the metatarsal) or from underneath, or move a toe-bending tendon when the joint has dislocated. Across 12 studies (537 tears), pain fell by about 5 points out of 10 and function scores rose by about 40 points out of 100, with follow-up to 2 years, and a 2017 review warned that these case series are open to bias. In 196 repairs from underneath, pain fell from 5.4 to 0.4 out of 10 and 88% were very satisfied.

Results depend on the grade: in 100 joints, all grades improved, but dislocated joints improved least. When the metatarsal is shortened anyway, repairing the plate as well gave better pain and quality of life at 1 year in 86 people, though they weren't randomised.

Older series reported satisfaction of 67% to 75%; in one, 31% had difficulty with weight-bearing exercise, and in another 25% didn't regain their previous function. In the UK cohort, surgery wasn't better than non-surgical care. Risks include the deformity coming back, stiffness, a toe that no longer touches the floor, pain moving to the next metatarsal, numbness, infection and wound problems.

Sources 20, 21, 22, 23, 24, 2, 4, 6, 25

How much pain is OK while you exercise?

An NHS health board's ruleEmerging evidence

During exercise, stay in the green or amber zones of the NHS board's pain scale. In the red zone, make the move smaller, do fewer repetitions, use less weight, go slower or rest longer between sets.

After exercise, pain should be back to its usual level within 30 minutes, and the next morning there should be no increase in pain or stiffness lasting longer than 60 minutes. Symptoms may rise slightly at first; contact your GP if the exercises cause a large increase in pain or nothing has changed after 12 weeks.

Our addition: while the plate heals, avoid anything that bends the toe up hard under your body weight, such as full tiptoe, kneeling on tucked toes, deep lunges onto the toes and demi-pointe. That's why the toe is taped downwards.

Sources 3, 2

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Protect the joint (about weeks 0 to 6)

Tape the toe slightly downwards for 4 to 6 weeks or until symptoms settle (steps in the notes below). Wear firm-soled or rocker-soled shoes, or a postoperative shoe if a clinician gives you one, and add a metatarsal pad 3 to 4 cm behind the joint once it has settled. No barefoot walking, high heels, flip-flops or flexible soles. Use ice for the first 2 to 3 days and in flare-ups, and avoid any sport or activity you think is causing the pain, which for most people means no running or jumping for now.

Seated calf stretch with a towel demonstrated on the 3D figure

3D demoSeated calf stretch with a towelBeginner · Other / check instructions

3 holds of 30 s, 3 times a day · NHS Ayrshire and Arran's dose

Harder: Wall calf stretch (gastrocnemius)

Wall calf stretch (gastrocnemius) demonstrated on the 3D figure

3D demoWall calf stretch (gastrocnemius)Beginner · A wall

3 holds of 30 s, 3 times a day · Keep the back heel on the floor. NHS Ayrshire and Arran's dose

Easier: Seated calf stretch with a towel · Harder: Toes-tucked kneeling (toe squat)

Soleus wall stretch demonstrated on the 3D figure

3D demoSoleus wall stretchBeginner · A wall

3 holds of 30 s, 3 times a day · NHS Ayrshire and Arran's dose

Easier: Seated calf stretch with a towel · Harder: Toes-tucked kneeling (toe squat)

Towel toe curl demonstrated on the 3D figure

3D demoTowel toe curlBeginner · Other / check instructions + A bench or box

3 to 5 pulls at first, building slowly to 15 a day · NHS Ayrshire and Arran's towel crunch

Harder: Short foot + toe splay

Stationary cycling demonstrated on the 3D figure

3D demoStationary cyclingBeginner · Cardio machine

10 to 20 min · Pedal with the arch or heel, in a stiff-soled shoe, as in our turf toe guide. Editorial

Harder: Air bike intervals

Glute bridge demonstrated on the 3D figure

3D demoGlute bridgeBeginner · No equipment

2 sets of 10 to 12 · Press through the heels. Editorial

Easier: Pelvic tilt into bridge · Harder: Glute kickback (quadruped hip extension)

Move on when: Walking in your firm-soled shoes is comfortable and the swelling under the joint is going down.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Strengthen the toes and foot (about weeks 4 to 12)

The NHS board's toe and foot exercises once a day (written steps in the notes below), keeping up the shoes, pads and taping that help.

3D demoTowel toe curlBeginner · Other / check instructions + A bench or box

Build to 15 a day · NHS Ayrshire and Arran's dose

Harder: Short foot + toe splay

Seated bent-knee calf raise (soleus raise) demonstrated on the 3D figure

3D demoSeated bent-knee calf raise (soleus raise)Beginner · A bench or box

2 to 3 sets of 15, a small lift only · Stop if the toe joint hurts. Editorial dose

Harder: Slow calf raise

Slow calf raise demonstrated on the 3D figure

3D demoSlow calf raiseBeginner · A wall

2 sets of 12, only halfway up · The move page says to stop short of full tiptoe with pain in the ball of the foot. The height is editorial

Easier: Seated bent-knee calf raise (soleus raise) · Harder: Standing dumbbell calf raise

Single-leg stand demonstrated on the 3D figure

3D demoSingle-leg standBeginner · A wall

3 holds of 30 s each leg, in shoes · Editorial dose

Easier: Tandem stance and heel-to-toe walk · Harder: Single-leg reach matrix

Tandem stance and heel-to-toe walk demonstrated on the 3D figure

3D demoTandem stance and heel-to-toe walkBeginner · A wall

Hold 20 s with each foot forward, then 3 walks of 15 steps, in shoes · The move page's dose

Easier: Semi-tandem stance · Harder: Single-leg stand

Move on when: The written exercises are easy at 3 sets of 15, half-height calf raises don't hurt the joint, and 30 minutes of walking in your shoes is comfortable.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Longer walks, running and sport (from about 3 months)

Build walking first, then running if you run, in firm-soled shoes; a stiff insole can help in sports shoes (our suggestion). Dancers come back to class gradually with taping and a pad, as in a published case, leaving rising onto the toes and demi-pointe, which load the joint most, until last.

Treadmill walking demonstrated on the 3D figure

3D demoTreadmill walkingBeginner · Cardio machine

Build your walking time · In your supportive shoes. Editorial

Harder: Treadmill jogging

3D demoStep-upBeginner · A step

3 sets of 8 each leg · The move page's dose

Easier: Low step-up · Harder: Dumbbell step-up

Elliptical trainer demonstrated on the 3D figure

3D demoElliptical trainerBeginner · Cardio machine

10 to 20 min · Keep the heels down. The move page's dose and cue

Harder: Stair-stepper machine

Treadmill jogging demonstrated on the 3D figure

3D demoTreadmill joggingIntermediate · Cardio machine

Walk-jog intervals · In firm-soled shoes. Editorial

Easier: Treadmill walking · Harder: Sprint intervals

Single-leg calf raise from a step demonstrated on the 3D figure

3D demoSingle-leg calf raise from a stepIntermediate · A step + A wall

2 to 3 sets of 8 to 10, halfway up at first · Only once full calf raises on two feet are comfortable. Editorial

Easier: Slow calf raise · Harder: Single-leg pogo hops

Ankle bounces (mini pogo) demonstrated on the 3D figure

3D demoAnkle bounces (mini pogo)Beginner · No equipment

2 sets of 20, in shoes · Last. Editorial

Harder: Pogo hops

Move on when: Walking, running and your sport are comfortable the next morning; a review says sport can resume once the joint is stable on the drawer test. If pain and deformity persist after about 3 months despite this, see a podiatrist or a foot and ankle surgeon.

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

Taping the toe

NHS Ayrshire and Arran's method holds the toe gently down and in line while the plate heals. A review tapes the toe about 10° downwards and warns that long-term taping can cause skin ulcers, so check your skin.

1. Cut a strip of tape about 8 to 9 cm long and 1 cm wide.
2. Thread it between the toes, over the base of the sore toe, and back between the toes on the other side.
3. Bring the toe down into line with the others: not too far, and not so tight that it affects the circulation.
4. Cross the two ends into a V under the ball of the foot, and secure them with more strips across the ball of the foot.
5. Replace it every 2 to 3 days, for 4 to 6 weeks or until your symptoms settle. If you have diabetes or numb feet, check the skin each time (our suggestion).

Sources 3, 2

Toe and foot exercises the figure can't show

These are five of NHS Ayrshire and Arran's strengthening exercises, once a day; the sixth, the towel crunch, is in the plan above. The board warns that they may slightly increase your symptoms at first.

1. Toe grip: sitting, grip a small ball, marbles or a pencil with your toes and try to pick it up. Start with 15, building to 3 sets of 15. If your foot cramps, rest for a minute and try again.
2. Toe raises: sitting with your feet flat, keep the big toe on the floor and lift the other toes, then relax them, 15 times. Then keep the small toes down and lift the big toe, 15 times. Steady the other toes with your fingers at first if you need to.
3. Band toe press: sitting, put a band under your toes and pull it back over your knee so the toes lift. Keeping the heel and ball of the foot down, slowly press the toes down to the floor against the band, then let them rise slowly. Build to 3 sets of 15.
4. Short foot: sitting with your toes straight and pressed gently into the floor, slide the ball of the foot back towards the heel so the arch lifts, without curling the toes. Hold for 5 seconds, 15 times, building to 3 sets of 15. Later, do it standing.
5. Forward lean: stand with your feet hip-width apart near a wall and lean your whole body forward from the ankles, so your toes press into the floor. Hold for 5 seconds, 15 times, building to 3 sets of 15.

Source 3

Shoes

Avoid going barefoot until the pain has gone, and avoid high heels, flexible soles and shoes that make you claw your toes, such as flip-flops, mules and Crocs. Look for a broad heel no higher than 1.5 inches, a firm sole, a deep toe box, and laces or Velcro; a rocker under the forefoot limits bending at the joint. The American Orthopaedic Foot & Ankle Society suggests a shoe that doesn't bend at the toe, such as a hiking boot or a stiff running shoe.

Sources 3, 6

After surgery (as your team allows)

Your surgical team's plan comes first. A review describes a postoperative shoe for 4 to 6 weeks with the toe taped downwards, then stiff-soled or rocker shoes while healing completes over 3 to 6 months. Any pins are usually removed at about 6 weeks, and the toe usually ends up stiffer than before.

An older NHS podiatric surgery leaflet describes 2 to 4 days of rest with the foot up, stitches out at 2 weeks, shoes at 4 to 8 weeks, daily toe strapping for 3 months, and sport considered after 3 months, while the review advises no high-impact sport for a year. The sources differ, so follow your team.

Sources 2, 6, 25

Positions to swap, and why

Habit or position	Why it matters	Instead
Walking barefoot, or in flip-flops, mules or Crocs	They make you claw your toes and give the joint no support, an NHS board explains.	Laced or strapped shoes with a firm sole.
High heels and soft, flexible soles	They increase the stress on the small joints of the forefoot.	A broad heel no higher than 1.5 inches and a firm sole, ideally with a rocker.
Kneeling on tucked toes	It bends the toes back hard under your body weight, stretching the healing plate.	Kneel on a cushion with the tops of your feet flat, or leave it out.
Full tiptoe calf raises	Rising fully onto the toes bends the toe joints back under load; the move page says to stop short of full tiptoe with pain in the ball of the foot.	Seated or half-height calf raises.Try: Seated bent-knee calf raise (soleus raise)
Calf raises with a towel under the toes	The towel bends the toes back under load.	Seated calf raises.Try: Seated bent-knee calf raise (soleus raise)
The plantar fascia stretch that pulls the toes back	Pulling the toes back stretches the healing plate (our reasoning).	The seated calf stretch with a towel, toes relaxed.Try: Seated calf stretch with a towel
A metatarsal pad placed right under the sore joint	The pad works from 3 to 4 cm behind the joint.	Ask a podiatrist or pharmacist to place it.
Repeated steroid injections into the joint	A review warns, as expert opinion, that they may weaken the plate and raise the risk of the toe dislocating.	Discuss it with your clinician; if one is given, tape the toe and limit weight-bearing for 6 weeks.
Expecting a toe straightener to correct the toe	No study shows a splint straightens a toe for good, as our hammer toe guide explains; taping protects the healing plate.	Taping, shoes and pads.

Routines to follow

Low-impact cardio workout (no jumping)

A 25-minute standing cardio circuit with no jumping: marching, step jacks, sit-to-stands, punches, step-ups and wall push-ups, with a seated option for most moves.

25 minBeginner9 movesA bench or box, A step

Balance exercises routine

Balance practice in 10 minutes: tandem stance, single-leg stands, marches, heel walks, tree pose and floor transfers.

10 minBeginner7 movesA wall, A bench or box

Foot and ankle strengthening routine: toes, arches, calves and balance

A 15-minute barefoot routine for stronger toes, arches, calves and ankles, finishing with balance. You need only a towel, a wall and a resistance band.

15 minBeginner11 movesA wall, Other / check instructions

More moves for this area

Questions people ask

What is the plantar plate?

A thick pad of tough tissue under the joint at the base of each toe. It stops the toe bending back too far and, with the ligaments at the sides of the joint, keeps the toe in line.

What does a plantar plate tear feel like?

Pain and swelling under the base of a toe, usually the second, like walking on a marble, often coming on gradually. Later, the toe may drift towards the big toe or lift off the floor.

Is it Morton's neuroma or a plantar plate tear?

Morton's neuroma gives burning or shooting pain and numbness between the toes, usually the third and fourth. A plantar plate tear hurts under the joint itself, and the toe may become loose or drift. They can occur together, and some people have had neuroma surgery for what was a plate tear.

Is it the same as turf toe?

Turf toe is the big toe's version, usually a sudden sports injury. Plantar plate tears of the smaller toes usually build up gradually, and our turf toe guide covers the big toe.

How is it diagnosed?

By examination: pain under the joint, and a drawer test in which the clinician pushes the base of the toe upwards to check for looseness. It's a useful test, but studies disagree on how accurate it is, so an ultrasound or MRI scan helps if the diagnosis is unclear.

How do I tape it?

Thread a strip of tape between the toes and over the base of the sore toe, bring the toe gently down into line, cross the ends under the ball of the foot and anchor them. An NHS board advises replacing it every 2 to 3 days for 4 to 6 weeks.

What shoes help?

Firm-soled, laced shoes with a deep toe box and a heel no higher than 1.5 inches, ideally with a rocker sole. Avoid going barefoot, high heels and flip-flops while it heals.

What exercises help?

Calf stretches and exercises for the small muscles of the foot, such as toe grips, towel crunches, toe raises, band toe presses and the short foot, from an NHS health board's programme. It can take up to 12 weeks to notice a big improvement.

Will it heal without surgery?

Often enough: in 154 people at a UK clinic, 64% were treated without surgery, and their pain, function and satisfaction didn't differ significantly from those who had surgery. An NHS board says ligament injuries in the foot can take 3 to 6 months to heal.

Should I have a steroid injection?

Discuss it carefully. Experts warn that repeated injections may weaken the plate and risk the toe dislocating, and if one is given, the toe should be taped and offloaded for 6 weeks.

When is surgery needed, and what's the recovery?

When pain and deformity persist despite shoes, taping and pads, or the toe is stiff and out of place. In case series, pain fell by about 5 points out of 10 after repair; recovery involves several weeks in a postoperative shoe, then months in stiff-soled shoes, and the toe is usually stiffer afterwards. Your surgical team sets the timeline.

Why is my second toe drifting or lifting?

The torn plate no longer holds the joint, so the toe drifts towards or over the big toe (a crossover toe) or lifts off the floor. It's a sign to get the toe checked.

Related exercise guides

Other pain guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.